Markell promises to change the DOC’s “Culture of Failure” (while campaigning for governor)

(Editor’s note: the following is a press release issued by Markell during his campaign for governor)

State Treasurer Jack Markell, the first statewide elected official to call for an investigation into the prison healthcare crisis, said July 30 that merely firing the contractor is not enough.

“It has been obvious, and today’s article in the News Journal just underscores, that CMS is failing, and as a result wasting millions of taxpayer dollars,” Markell said. “The real question is how are we going to address these problems? If the Minner-Carney administration couldn’t hold this vendor’s feet to the fire, then what is going to change when we hire another medical provider? How are we going to change the culture of failure that has pervaded our prison medical system?”

In response to an article in today’s News Journal that reported that serious problems persist despite significant taxpayer investment, Markell issued a statement outlining how his policy proposals can help solve the ongoing problems in the prison system.

“We can do better. The problems in our prisons are serious and well-documented. But for some reason we can’t seem to make the right changes. First and foremost we need to make sure we are respecting basic civil rights, but there’s another problem. We hire external contractors, and don’t hold them accountable. It’s as simple as this: We’re not getting what we pay for, and taxpayers are outraged. As governor, I will provide responsible fiscal leadership and ensure that taxpayers receive the best value for their dollar.”

Markell released his Fiscal Responsibility plan in May, and now he is showing how these plans can help fix the problems that continue to arise in Delaware’s prison system. Markell’s plan will create a culture of smarter planning and implement a statewide performance review to evaluate long-funded projects for their true effectiveness. Many other states have conducted comprehensive performance reviews within the past five years, and the ongoing savings generated from a performance audit like the one Markell calls for in Delaware average 2 to 3 percent of these states’ general fund budgets. ForDelaware, that would mean roughly $75 million in annual savings.

“I will make sure that the very first area of state government examined with this performance review will be the health care unit of the Department of Correction. This will be a strong proactive step. My administration will not be one that waits for problems to be covered in the news before looking for solutions.”

It’s clear that the central problem in the continued failure of Delaware’s corrections system to get out from under federal supervision is the continued unsatisfactory performance of the vendor, Correctional Medical Services (CMS), to which the Minner-Carney Administration has delegated responsibility for correctional health services, and the Administration’s inability to effectively manage the vendor.

There can be no more apt metaphor than the repeated criticism in the independent monitor’s report of the ’lack of stable and effective leadership.’

An active and engaged state Administration could be doing more to make sure that CMS – or any vendor – is meeting its legal and moral responsibilities. At a minimum, the Administration should demand that CMS’s contract be amended to include financial consequences for CMS’s failure to meet measurable performance indicators – especially for providing health services within a specified timeframe from prisoner request. Underperformance like that reported repeatedly by the independent monitor shouldn’t be allowed to continue without consequences: There should be performance measures, constant monitoring by the state itself, and financial penalties – culminating in contract termination, if necessary – to enforce vendor performance.

“Last week, I toured the infirmary of the Howard Young Correctional Center,” Markell said. “Prison staff are struggling to keep up with overtaxed, overcrowded facilities and they need the appropriate resources and tools to more effectively manage the contractor.”

The Administration could take numerous additional steps to ensure that the State meets its legal and constitutional obligations. We must ensure that decisions about health care, especially the need for urgent care, are made by health care professionals only. We should establish an independent state unit to regularly review health care services provided for quality of care and adequacy, instead of just leaving it to the federal government, the independent monitor, and the news media to keep an eye on whether a vital state function is being adequately carried out. We need to improve recruitment, training and retention of health care professionals, working with local hospitals to provide Continuing Medical Education, and we must make translation services available to assist all prisoners who do not speak English.

What we don’t need is another commission, task force, or study group to figure out a new Administration position sometime next year. We don’t need four more years of incremental improvement, at best, like the last four. As in so many other areas of state government, it’s time for a change.”

Markell has other plans to ease the burden on the prison system, which will reduce the cost to taxpayers for prison health care in the long run. To put youths on a path toward success instead of a trajectory toward a jail cell, Markell’s Plan to Strengthen Communities directs state law-enforcement agencies to extensively analyze juvenile-arrest data. More than 7,700 juveniles are arrested each year in our state. In many instances, with appropriate intervention and follow-up, we can ensure that the youth stays clear of trouble in the future.

Markell also will work with the state’s drug courts to assess whether additional resources could expand treatment services and other oversight and monitoring to a greater number of offenders. The drug courts divert offenders from the prison system and get them the help they need to turn their lives around.

And because the vast majority of inmates are released, Markell will allocate as much as $1 million to help the Department of Correction improve its inmate re-entry services. The expanded re-entry programs will develop individual plans for each offender that identify potential difficulties and agencies and organizations that can provide assistance.

“We have to start planning for inmates’ releases the day they enter our correction system,” Markell said. “Everyone is better off when ex-offenders become productive, law-abiding members of society. But that cannot happen if they do not receive adequate health care in our prisons.”